Newly Added CPT Codes for COVID-19 Antibody Tests

The American Medical Association (AMA) on April 10, 2020, announced updates to Current Procedural Terminology (CPT®) that include two CPT Codes for COVID-19 Antibody Tests, intended to report when patients receive blood tests that detect COVID-19 antibodies. The updates were approved during a special meeting of the CPT Editorial Panel, the independent body convened by the AMA with sole authority to expedite the review of proposed changes and additions to the CPT code set.

CPT Codes for COVID-19 Antibody Tests:

The expedited approval of new CPT Codes for COVID-19 Antibody Tests is an important step that enhances the reporting of innovative tools now available to advance medicine’s overarching goals of reducing the COVID-19 disease burden, improving health outcomes, and reducing long-term care costs. Antibody testing that identifies patients that have been exposed to the novel coronavirus (SARS-CoV-2) and developed an immune response is likely to have important public health implications by providing a clearer picture of the prevalence of the disease in the U.S.

The new codes are intended for use as the industry standard for accurate reporting and tracking of blood tests performed to specifically detect antibodies associated with the SARS-CoV-2 virus. These two new codes are effective immediately. Code 86328 was established for antibody tests using a single-step method immunoassay. This testing method typically includes a strip with all of the critical components for the assay and is appropriate for a point of care platform. Code 86769 was established for antibody tests using a multiple-step method.

Along with newly added CPT Codes for COVID-19 Antibody Tests that are 86328 and 86769, we have provided all pathology and laboratory codes for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]). Revision of code 86318, addition of two Category I Pathology and Laboratory codes (86328, 86769), revision of guidelines, and the addition of three parenthetical notes following codes 86328, 86635, and 86769 accepted at the April 2020 CPT Editorial Panel meeting. Note that code 86769 will be a child code under parent code 86710. It is represented here as the full long descriptor including the language from parent code 86710.

The following code was accepted at the March 2020 CPT Editorial Panel meeting for the 2021 CPT production cycle. This code is effective immediately on March 13, 2020. Note that code 87635 will be a child code under parent code 87471. It is represented here as the full long descriptor including the language from parent code 87471.

Code	Long Code Descriptor	Effective	Publication
87635	Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique	March 13, 2020	CPT® 2021

The following codes, guidelines, and parenthetical notes were accepted and/or revised at the April 2020 CPT Editorial Panel meeting for the 2021 CPT production cycle. The codes, guidelines, and parenthetical notes are effective immediately on April 10, 2020.

Code	Long Code Descriptor	Effective	Publication
86318	Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (e.g., reagent strip);	April 10, 2020	CPT® 2021
86328	Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) (For severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease {COVID-19}] antibody testing using the multiple-step method, use 86769) The following codes (86602-86804) are qualitative or semiquantitative immunoassays performed by multiple-step methods for the detection of antibodies to infectious agents. For immunoassays by single-step method (e.g., reagent strips), use see codes 86318, 86328. Procedures for the identification of antibodies should be coded as precisely as possible. For example, an antibody to a virus could be coded with increasing specificity for virus, family, genus, species, or type. In some cases, further precision may be added to codes by specifying the class of immunoglobulin being detected. When multiple tests are done to detect antibodies to organisms classified more precisely than the specificity allowed by available codes, it is appropriate to code each as a separate service. For example, a test for antibodies to an enterovirus is coded as 86658. Coxsackie viruses are enteroviruses, but there are no codes for the individual species of enterovirus. If assays are performed for antibodies to coxsackie A and B species, each assay should be separately coded. Similarly, if multiple assays are performed for antibodies of different immunoglobulin classes, each assay should be coded separately. When a coding option exists for reporting IgM specific antibodies (e.g., 86632), the corresponding nonspecific code (e.g., 86631) may be reported for the performance of either an antibody analysis not specific for a particular immunoglobulin class or for an IgG analysis. (For the detection of antibodies other than those to infectious agents, see specific antibody [eg, 86021- 86023, 86376, 86800, 86850-86870] or specific method [e.g., 83516, 86255, 86256]) (For infectious agent/antigen detection, see 87260-87899)	Revised Guidelines Effective April 10, 2020	Revised Guidelines Publication CPT® 2021
86602	Antibody; actinomyces
86635	Coccidioides (For severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease {COVID-19}] antibody testing, see 86328, 86769)	Parenthetical Note Effective April 10, 2020	Parenthetical Note Publication CPT® 2021
86769	Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) (For severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] [Coronavirus disease {COVID-19}] antibody testing using single-step method, use 86328)	April 10, 2020	CPT® 2021

Visit our blog section for more billing resources on COVID-19. These resources will help you to prepare your practice and address patient concerns during the COVID-19 pandemic. To get reimbursed for medical services rendered during the COVID-19 pandemic, contact Medical Billers and Coders (MBC) at 888-357-3226/info@medicalbillersandcoders.com